Joint pain (arthralgia) is a very common problem that can be associated with infection or toxicity, trauma, inflammation or deterioration of the cartilage.
In most cases, the joint pain goes away on its own within a few days. However, some situations require you to see a doctor as soon as possible. It is not easy even for an experienced specialist to determine exactly why the joints hurt, as the first symptoms can be deceptive, and the full picture of the disease sometimes manifests itself only within 1-2 months or more.
The information in this article will help you navigate the variety of diseases and conditions that cause arthralgia. And modern diagnostic methods will allow you to establish the exact cause of the ailment and choose the right treatment tactics together with a doctor.
In this article, we will look at situations where multiple joints throughout the body hurt. Sometimes one starts to ache and other joints quickly join him. It happens that the pain seems to migrate from one part of the body to another over the course of several days or weeks. A number of diseases cause pain in a group of joints in the form of attacks - convulsions, when the pain subsides and then reappears.
Joint pain with viral infections
Most often, arthralgia occurs with various viral infections: due to the direct effect of viruses on the joints or under the influence of toxins that accumulate in the blood during the acute period of many infectious diseases.
Most often, pain appears in the small joints of the arms and legs, in the knee joints, and sometimes in the joints of the spine. The pain is not strong, aching. It is called joint pain. Mobility is usually not impaired, there is no swelling or redness. In some cases, a hives-like rash may appear that disappears quickly. In most cases, viral arthralgia becomes the first symptom of malaise and is accompanied by fever, muscle aches and weakness.
Despite the deterioration in general well-being, joint pain in viral diseases is usually not a cause for serious concern. Relief can be provided by taking non-steroidal anti-inflammatory drugs, drinking plenty of fluids, and resting. After a few days, the pain subsides and the function of the joint is fully restored. There are no irreversible changes in the structure of the joint.
Viral arthralgias are characteristic of, for example, influenza, hepatitis, rubella, mumps (in adults).
Reactive arthritis
This is a group of diseases in which joint pain occurs after an infection, both viral and bacterial. The immediate cause of reactive arthritis is a failure of the immune system, which causes inflammation of the joints, even though they have not been affected by the infection.
Joint pain most often appears 1-3 weeks after acute respiratory infections, intestinal infections, or diseases of the genitourinary system, for example, urethritis or genital infections. Unlike viral arthralgias, joint pain is intense, accompanied by edema and reduced mobility. Body temperature can rise. Arthritis often begins with involvement of a knee or ankle joint. Within 1-2 weeks, the pain in the joints of the other half of the body joins, the small joints in the arms and legs begin to ache. Sometimes the joints in the spine hurt.
Joint pain usually subsides with treatment or on its own, leaving no sequelae. However, some types of reactive arthritis are chronic and occasionally exacerbated.
Reiter's disease- one of the types of reactive arthritis that develops after the transferred chlamydia and can have a chronic course. Joint pain in Reiter's disease is usually preceded by a violation of urination - a manifestation of chlamydial urethritis (inflammation of the urethra), which often goes unnoticed. Then eye problems appear, conjunctivitis develops. For treatment, you need to consult a doctor.
Reactive arthritis can develop after adenovirus infection, genital infections (especially chlamydia or gonorrhea), intestinal infections associated with Salmonella, Klebsiella, Shigella infection, etc.
Joint pain when cartilage is worn away
Diseases that are accompanied by gradual wear of the cartilage on the articular surfaces of the bones are called degenerative. They are most common at the age of 40-60 and above, but also occur in younger people, such as those with joint injuries, professional athletes exposed to frequent intense exertion, and obese people.
Deforming osteoarthritis (osteoarthritis, DOA)- This is a disease of the large joints of the legs - knees and hip joints, which bear most of the load when walking. The pain comes on gradually. In the morning, after rest, the state of health improves, and in the evening and night after long walks, runs and other stresses, it worsens. Inflammatory changes: edema, redness are usually not pronounced and can appear only in advanced cases. But there are often complaints of crepitus in the joints. Over the years, the disease progresses. It is almost impossible to cure deforming arthrosis, it is only possible to slow down the destruction of cartilage. To restore mobility, they resort to surgery.
Spinal osteochondritisIt is another common degenerative disease. Its cause is the thinning and destruction of the cartilage between the vertebrae. The decrease in the thickness of the cartilage leads to compression of the nerves extending from the spinal cord and blood vessels, which, in addition to pain in the joints of the spine, causes many different symptoms. For example: headache, dizziness, pain and numbness in the arms, shoulder joints, pain and disruptions in the heart, chest, leg pain, etc. A neurologist usually deals with the diagnosis and treatment of osteochondrosis.
Autoimmune Diseases as a Cause of Joint Pain
Autoimmune diseases are a large group of diseases, the causes of which are not fully known. All these diseases share the peculiarity of the immune system: the cells of the immune system begin to attack their own tissues and organs of the body, causing inflammation. Autoimmune diseases, in contrast to degenerative diseases, are more likely to develop in childhood or young people. Their first manifestation is often joint pain.
Joint pain is usually volatile: today one joint hurts, tomorrow another, the day after tomorrow - a third. Arthralgia is accompanied by edema, redness of the skin, reduced mobility of the joints, and sometimes fever. After a few days or weeks, the joint pain goes away, but after a while it comes back. Over time, the joints can deform significantly and lose mobility. A characteristic sign of autoimmune joint inflammation is morning stiffness. In the early hours of the morning, the affected joints should be kneaded for 30 minutes to 2-3 hours or more. The stronger the load on the joint the day before, the more time you need to spend on warming up.
Gradually, the symptoms of damage to other organs join the arthralgia: heart, kidneys, skin, blood vessels, etc. Without treatment, the disease progresses. It is impossible to cure it, but modern drugs can slow down the process. Therefore, the earlier the treatment is started, the better the result.
Rheumatoid arthritis is the most common autoimmune disease, in which the joints are mainly affected: they start to hurt a lot, turn red and swell. Most often, the disease begins with pain in the small joints of the arms and legs: fingers, joints of the hand or foot, less often - with the defeat of one knee, ankle or elbow joint, and then pains in others parts of the body join.
Systemic lupus erythematosus- a rarer disease, more susceptible to young women. It is characterized by flying pains in various joints of the body, deformation of the fingers, the appearance of a rash, especially characteristic on the face - redness on the forehead and cheeks in the form of butterfly wings. Joint pain may be accompanied by disruptions and discomfort in the heart and chest, low-grade fever, weakness, weight loss, increased blood pressure, back pain, edema.
Ankylosing spondylitis- unlike lupus, it affects men more often. The disease begins with pain in the joints of the spine, in the lumbar region, in the sacrum, in the pelvis. Gradually, the pain spreads upward to other parts of the spine. In addition to pain, stiffness, decreased flexibility and, over time, gait disturbances and complete immobility of the spinal joints are characteristic. In the early stages, ankylosing spondylitis can easily be confused with osteochondrosis. However, the first disease develops in young men and the second in the elderly. As a diagnostic test, an X-ray of the sacroiliac joint is taken, the point where the spine and pelvic bones meet. Based on the results of the study, the doctor can confirm or deny the diagnosis.
Joint pain with psoriasis
Psoriasis is a skin disease in which a characteristic rash appears on the surface of the body. Sometimes psoriasis affects the joints. The joints of the hands and feet, fingers and toes, less often the spine, usually hurt and swell. A distinctive feature of arthritis in psoriasis is an asymmetrical lesion. The skin over the joints may have a bluish-purple color and nail damage occurs. Over time, deformities and subluxations of the joints develop (the fingers begin to bend in an atypical direction).
Arthralgia with rheumatism
Rheumatism (acute rheumatic fever) is a serious disease caused by streptococci. Rheumatism is characterized by very severe pain in the large joints of the legs and arms, which appear 2-3 weeks after a sore throat or scarlet fever. It most often develops in children. The pain is so bad that you cannot touch the joint, you cannot move. The joints swell, turn red, and the temperature rises. First some joints hurt, then others, usually symmetrical. Even without treatment, the pain disappears on its own and the function of the joint is fully restored. However, after a while, severe symptoms of heart damage appear. Rheumatism requires urgent medical attention. Only with timely treatment can damage to the heart and other organs be avoided.
How to examine sore joints?
There are various examination methods for joint pain. As a rule, they are used in combination.
blood test Blood- is one of the most common tests for joint disorders. With the help of this study, it is possible to determine the presence of inflammation or suggest a degenerative nature of the disease, identify signs of infection and using immunological tests or the polymerase chain reaction (PCR) method, accurately determine the causative agent of the disease in case of infectious or reactive arthritis. A blood test shows possible metabolic disorders, the state of internal organs.
Study of the synovial fluid- fluid that washes the surface of the joint. With the help of it, the joint surfaces are nourished, and friction during movement is also reduced. Based on the composition of the synovial fluid, the laboratory assistant draws conclusions about the presence of inflammation or infection in the joint, the processes of destruction and nutrition of cartilage, the accumulation of salts that can cause pain (for example, with gout) . Synovial fluid is taken for analysis using a needle, which is inserted into the joint cavity after local anesthesia.
Joint radiography and computed tomography (CT)- a method that allows you to consider the structure of the bony parts of the joint, and also indirectly judge the condition of the cartilage by the size of the joint space - the distance between the bones in the joint. X-ray examination is prescribed among the first methods for joint pain. The x-ray shows mechanical damage to the bones (fractures and cracks), joint deformities (subluxations and dislocations), formation of bone growths or defects, bone density, and other criteria that help the doctor identify the cause of joint pain. Computed tomography is also an X-ray research method. With a CT scan, the doctor receives a series of layer-by-layer images of the joint, which in some cases provide more complete information about the disease.
Ultrasound and MRI of the joints- the methods are different in nature, but similar in terms of purpose. With the help of ultrasound or MRI, it is possible to obtain information about the condition of the soft tissues of the joint and cartilage. Ultrasound and MRI show the thickness of the cartilage, its defects, the presence of foreign inclusions in the joint, and also help determine the viscosity and amount of synovial fluid.
Arthroscopy- a method of visual examination of the joint using microsurgical instruments which, after anesthesia, are introduced into the cavity of the diseased joint. During arthroscopy, the doctor has the opportunity to examine the internal structure of the joint with his eyes, notice its damage and changes, and also take pieces of the synovial membrane of the joint and its other structures for analysis. If necessary, after the examination, the doctor can immediately carry out the necessary therapeutic manipulations. Everything that happens during arthroscopy is recorded on a disk or other storage medium, so after the procedure you can consult with other specialists.
Joint treatment
If you have joint pain, find a good therapist or pediatrician for children. He will conduct an initial diagnosis and, if necessary, refer you to a specialized specialist for treatment. If joint pain is associated with osteoarthritis or arthritis, the treatment will most likely be managed by a rheumatologist found here.
If the cause of the arthralgia is an inflammatory response, drugs are used to treat the joints that can reduce inflammation. These are, first of all, non-steroidal anti-inflammatory drugs (NSAIDs): indomethacin, ibuprofen, diclofenac, nimesulide, meloxicam and many others. If these drugs are not effective enough, then drugs from the corticosteroid group are prescribed in the form of injections into the joint cavity or tablets. When an infection causes pain, antibiotics are given.
For autoimmune diseases, special treatment regimens are used. For constant admission by the doctor, the minimum effective doses of drugs are selected that can strongly suppress the inflammatory response or suppress the immune system. For example: sulfosalazine, methotrexate, cyclophosphamide, azatiaprine, cyclosporine, infliximab, rituximab and others.
Specific drugs are not yet known for degenerative joint diseases (osteochondrosis, arthrosis). Treatment of diseased joints consists in prescribing anti-inflammatory and analgesic drugs during an exacerbation, as well as taking metabolic agents based on chondroetin sulfates and hyaluronic acid. Although the effectiveness of the latter is not currently recognized by all doctors.
If the function of the joint is irreversibly deteriorated, they resort to surgery. Currently, there are various methods of endoprostheses that allow the implantation of artificial joints or parts of them instead of damaged or worn ones.